Convenience, not Cost

May 07, 1993

Like clean drinking water or safe sewage systems, immunizing children against preventable childhood diseases should be basic to the public health system of any society. The fact that immunization rates of children in the United States rank with Bolivia and Haiti as among the lowest in the Western hemisphere speaks volumes about the delivery of health care in this country. So there was undeniable allure in the Clinton administration's proposal to provide immunizations free to all children regardless of need.

But spending $1.1 billion each year for free vaccines won't necessarily solve the problem, as 11 states that already foot the bill have learned. When parents are taught the importance of immunizing children, they rarely let cost stand in the way. Convenience and keeping track of immunization records are far bigger problems for many families. There is a case to be made for spending much more money on immunization programs. But in our view that money would be far better spent on the administration's plans to improve service at public health clinics and to undertake better outreach and education efforts.

ATrue, the cost of fully immunizing a child has risen dramatically over the past decade. But the increase cannot be written off as just another case of pharmaceutical greed. Liability costs have almost doubled the cost of some vaccines. In addition, routine immunizations now include two new vaccines and an extra dose for one longer-established serum. One of the new vaccines protects children against the most common cause of meningitis, saving an estimated 1,000 lives each year.

Too many examples of apparent price-gouging by the pharmaceutical industry have tarnished its claims to sympathy. But the fact remains liability issues prompted the majority of xTC companies to abandon the vaccine field during the 1980s. That's regrettable, because immunizations are the simplest and most cost-effective form of health care there is -- even factoring in claims that vaccines sometimes have damaging side-effects.

Consider, for instance, how life would improve for millions of families if researchers succeed in creating a vaccine to immunize infants against common causes of ear infections. Pharmaceutical companies rightly worry how they can continue to invest in that kind of competitive, long-range research if the market for vaccines is limited to one buyer -- the federal government.

The administration's emphasis on childhood immunizations is one of the best things to happen to public health in years. Its new-found willingness to be flexible in devising ways to reach the goal of universal immunization is equally good news.